No barriers to health

A scoping study was commissioned by Healthwatch East Sussex, and undertaken between November 2013 and July 2014 by the University of Brighton. Its main aim is to understand how well language services meet the needs of Deaf people, Black and Minority Ethnic (BME) groups, and others who require communication support, and to identify barriers and improvements needed. 

The study found that, although there is a formal commitment to providing professional interpreting services and bilingual advocacy, access to these services is inconsistent in practice. Patients continue to report difficulties obtaining interpreters or being incorrectly told that such support is unavailable. 

A key issue identified is that processes for booking interpreters are often complex and poorly understood by staff, with multiple layers of authorisation and inconsistent procedures across different NHS Trusts. This complexity can delay or prevent access to interpreters and places responsibility on frontline staff who may lack training or awareness. 

The report highlights that different organisations use different systems and contracts, such as the Sussex-wide SUSTI framework, but variation between Trusts creates confusion, particularly when patients move between services. This can result in interruptions to care, including difficulties ensuring continuity with the same interpreter. 

Demand for interpreting services has increased significantly in recent years, especially for BME communities, while provision for Deaf people remains more limited. There are also challenges in urgent and out-of-hours situations, where interpreters may not be available when needed. Remote interpreting technologies exist but are not yet fully developed or consistently accessible. 

The report also identifies specific barriers for certain groups, including people with learning disabilities who may require adapted communication methods, carers who may also need interpretation support, and Gypsy and Traveller communities who may face literacy issues. 

Another major concern is staff awareness and attitudes. Some staff lack knowledge of policies or incorrectly prioritise cost considerations over patients’ rights to communication support, which can result in services not being offered even when required. 

The report raises concerns about quality and standards of interpreting, noting that unqualified or informal interpreters (such as family members) are sometimes used, which can lead to misunderstandings and risks to patient safety. It recommends stronger professional standards and accreditation. 

Overall, the report concludes that while systems are in place, significant improvements are needed to ensure equitable access to interpreting services. Key recommendations include simplifying booking processes, increasing staff training and awareness, improving coordination between organisations, expanding remote interpreting options, monitoring service quality, and ensuring all interpreters are professionally qualified and accessible to patients when needed.